Physiologic jaundice; when does it appear and how is it managed?

• A. Appears within 24–48 hours after birth; managed with monitoring and feeding; phototherapy if bilirubin rises significantly
• B. Appears at birth; requires exchange transfusion
• C. Appears after 2 weeks; treated with antibiotics
• D. Never occurs in term newborns

Answer: (A)

Physiologic jaundice happens because a newborn’s liver is still maturing and has slower ability to conjugate and excrete bilirubin, plus there’s higher bilirubin production from extra red blood cell turnover after birth. In term babies, it usually becomes noticeable after the first day of life and often appears within the first 24 to 48 hours, with bilirubin peaking around day 2 to 3 and then declining over the next several days.

Management centers on aiding elimination and monitoring. Encourage and support regular feeding to promote gut motility and bilirubin excretion, and ensure adequate hydration. Bilirubin levels are tracked, and phototherapy is used when levels reach the established threshold for age in hours and risk factors. Exchange transfusion is reserved for very high or non-responsive cases or if there are signs of bilirubin-induced complications.

So the timing described—appearing within 24–48 hours—and the approach of monitoring with feeding support plus phototherapy when needed align with physiologic jaundice in the healthy term newborn.